Multidisciplinary Intraoperative Assessment of Breast Specimens Reduces Number of Positive Margins View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10

AUTHORS

S. E. Tevis, H. B. Neuman, E. A. Mittendorf, H. M. Kuerer, I. Bedrosian, S. M. DeSnyder, A. M. Thompson, D. M. Black, M. E. Scoggins, A. A. Sahin, K. K. Hunt, A. S. Caudle

ABSTRACT

BACKGROUND: Successful breast-conserving surgery requires achieving negative margins. At our institution, the whole surgical specimen is imaged and then serially sectioned with repeat imaging. A multidisciplinary discussion then determines need for excision of additional margins. The goal of this study was to determine the benefit of each component of this approach in reducing the number of positive margin. METHODS: This single-institution, prospective study included ten breast surgical oncologists who were surveyed to ascertain whether they would have taken additional margins based their review of whole specimen images (WSI) and review of serially sectioned images (SSI). These results were compared with the multidisciplinary decisions (MDD) and pathology results. Margin status was defined using consensus guidelines. RESULTS: One hundred surveys were completed. Margins on the original specimen were positive or close in 21%. After WSI, surgeons reported that they would have taken additional margins in 26 cases, reducing the number of positive/close margins from 21 to 13% (p < 0.001). After SSI, 52 would have taken additional margins; however, the number of positive/close margins remained 13%. MDD resulted in additional margins taken in 56 cases, reducing the number of positive/close margins to 7% (p < 0.001 compared with SSI). CONCLUSIONS: While surgeon review of specimen radiographs can decrease the number of positive or close margins from 21 to 13%, more rigorous multidisciplinary, intraoperative margin assessment reduces the number of close or positive margins to 7%. More... »

PAGES

2932-2938

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1245/s10434-018-6607-2

    DOI

    http://dx.doi.org/10.1245/s10434-018-6607-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1105151858

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29947001


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